Credit Application
LARKHILL LINGERIE INC.
www.larkhill.com
email: marketing@larkhill.com

Date this form filled out ___________________
 
Name of Business .
Name of Owner .
Name of Store Mgr. .
Years in Business under this name
0 - 2 years  3 - 5 years  6 +  years
Additional Stores operating under this name
No  Yes             if Yes, the number of those stores  ____
Street Address .
Street Address .
Province                                                            Postal Code
.
tel:  (  ______ ) _______ - __________ ext _______ fax:  (  ______ ) _______ - __________ ext _______
email: web site:
.
Institution you bank with: Please check appropriate box
Bank of Montreal
Scotiabank
CIBC
National Trust
TD Bank / Canada Trust
Royal Bank
TD Bank / Canada Trust
Credit Union (specifiy)
other .. write in name
Bank Branch Address 

_______________________________________                        (City) _________________

.
References
Name of  business tel: contact City
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